14ymedio, Miami, 17 April 2017 — Cuban professional services abroad are the main source of foreign exchange for the government and represent an estimated 11.543 billion dollars annually, according to an article published in the official press by the island’s former Minister of the Economy, José Luis Rodríguez.
Most of the income comes from the more than 50,000 healthcare professionals who work in some sixty countries around the world, nearly half of whom are doctors and specialists in different branches of medicine.
The recently published Health Statistics Yearbook 2016 reveals that Cuban professionals are in 24 countries in Latin America and the Caribbean, in almost three dozen African countries, and in the Middle East, East Asia and the Pacific. In Europe they are present in Russia and Portugal.
In 2014, the Cuban government said that the country obtained 8.2 billion dollars for the provision of health services abroad, a figure that would have declined after the fall in oil prices and the crisis in Venezuela. It also maintains other cooperation programs from which it receives dividends, such as the export of professionals in education, technicians, engineers and athletes.
More than 28,000 Cuban professionals remain in Venezuela as part of the agreements that the government of Hugo Chávez government and his successor, Nicolás Maduro, pay for with oil
Venezuela is the main market for Cuban professionals. In the health sector alone it is estimated that more than 28,000 Cuban professionals remain in that country as a part of the agreements that the government of Hugo Chaves and his successor, Nicolás Maduro, pay for with oil.
According to Maduro, Venezuela has invested more than 250 billion dollars in health agreements between both nations since 1999. More than 124,000 Cuban professionals in that sector have worked in Venezuela, said the president.
The second country in terms of numbers of Cuban professionals is Brazil, which since the beginning of the More Doctors program, in 2013, has contracted through the Pan American Health Organization for 11,400 Cuban professionals.
Following the ousting of President Dilma Rousseff, Cuba renegotiated the contract and gained a 9% increase in the salaries of professionals. The country also renewed the contract for the island’s professionals for three more years. However, the thousands of Cubans who have contracted marriages with Brazilians to obtain permanent residence, and the more than 1,600 who are in the process of validating their credentials in Brazil and separating themselves from the guardianship of Havana, have caused Cuba to suspend the sending of new doctors to Brazil to avoid desertions.
The Cuban government, through the Cuban Medical Services Dealer, offers workers on the island, whose salary is around $40 a month, some benefits and better remuneration if they will agree to go on the missions. In no case do the professionals negotiate their contracts directly with the employer, which is why the Cuban authorities keep between 50 and 75% of the income.
The thousands of Cubans who have contracted marriage with Brazilians to obtain permanent residence and the more than 1,600 who are in the process of validating their credentials in Brazil have caused Cuba to suspend the sending of new doctors to that country to avoid desertions
Family members are not allowed to stay for more than three months with the professionals on “medical missions,” who must return to the island when they finish their contracts. If they do not, they are prohibited from returning to Cuba for eight years, according to the current immigration regulations.
Some organizations like Solidarity Without Borders, which helps Cuban doctors who decide to defect from government missions, denounce these contracts as “the greatest human trafficking case in modern history.”
Until January 12th of this year, the United States maintained a special welcome program known as Cuban Medical Professional Parole (CMPP) to welcome health professionals who escaped medical missions.
The CMPP, established in 2006 under the administration of George Bush, was a point of friction with Havana, which called for its elimination. More than 8,000 professionals took advantage of this program. Cuban-American members of Congress from Florida have vowed to work for its reinstatement.
The health system on the island is free, state-run and universal. A total of 493,368 people work in the system, of which 16,852 are dentists, 89,072 are nurses and 63,471 are technicians.
After the end of the Soviet subsidy the quality of the healthcare system collapsed. Cubans often complain about the absence of the specialists who have been sent to third countries. Recently the government began to deliver symbolic bills to remind citizens that “public health is free, but it costs.”